"After investing more than $30 billion in health IT, we haven't improved the administrative efficiency," says Schulman. "That was one of the big promises of digitizing records."

The researchers examined the use of a certified EHR at a large academic healthcare system, which found estimated costs for billing and insurance-related functions were substantial and varied by the type of clinical encounter.

The team looked at five different patient encounters:

discharged emergency department visits

primary care visits

ambulatory surgical procedures

general medicine inpatient stays

inpatient surgical procedures

They found that the estimated processing time and total costs for billing and insurance-related activities were were "13 minutes and $20.49 for a primary care visit, 32 minutes and $61.54 for an emergency department visit, 73 minutes and $124.26 for a general inpatient stay, 75 minutes and $170.40 for an ambulatory surgery procedure, and 100 minutes and $215.10 for an inpatient surgical procedure. All estimates include costs for both professional billing and hospital billing." These are contrasted with the billing costs for professional services ranging "from 3.1% to 25.3% of professional revenue, which represented $20 to $215 in absolute costs per visit."

Our readers will want to see the study and to take in the limitations on the way to considering policy solutions to reduce these expenditures.

"We hope this will be a wake-up call that it's time to focus on administrative simplification."

"We hope this will be a wake-up call that it's time to focus on administrative simplification," says Schulman.

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